Carpal tunnel syndrome and associated nail changes: Review and examples from the author's practice - 09/11/20
Abstract |
Carpal tunnel syndrome (CTS) is commonly seen by general practitioners and often presents with neurologic symptoms of nocturnal pain and paresthesia along the median nerve distribution. Approximately 20% of patients also present with cutaneous findings (ulcerations, blistering, sclerodactyly, nail dystrophy) characterizing a severe form called necrotic CTS. Necrotic CTS can also be associated with bone changes (acro-osteolysis). In the author's practice, combined nail and skin findings are not an uncommon presentation of CTS, although this form remains overlooked and underreported in the dermatological textbooks and studies. This manuscript aims to review the literature on CTS cases, with a specific focus on using associated nail findings as diagnostic clues. The literature review along with a few additional recent cases from the author's practice demonstrate that CTS is frequently accompanied by a variety of nail changes including koilonychia, longitudinal fissuring, Beau's lines, onychomadesis, melanonychia, nail thickening, hyperkeratosis, and ischemic ulcerations with paronychia. Furthermore, when these changes are limited to the second and third fingernails, they should prompt the diagnosis of CTS. Once suspected, diagnostic evaluation is not difficult and surgical management can resolve cutaneous findings and prevent irreversible changes such as acro-osteolysis.
Le texte complet de cet article est disponible en PDF.Key words : acro-osteolysis, carpal tunnel syndrome, diagnostic clue, index fingernail, middle fingernail, nail changes, nail dystrophy, surgical decompression, topical nitroglycerin
Abbreviation used : CTS
Plan
Funding sources: None. |
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Conflicts of interest: Dr Tosti has served as a consultant for Almirall, Procter & Gamble, DS Laboratories, Monat, Pfizer, and Thirty Madison; on the advisory board for Leo Pharma; and as a principal investigator for Incyte, Aclaris, Lilly, and Nutrafol. Ms Egger has no conflicts of interest to declare. |
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IRB approval status: Not applicable. |
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Reprints not available from the authors. |
Vol 83 - N° 6
P. 1724-1729 - décembre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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